大鼠侧位液压冲击脑损伤动物模型的建立及病理学改变

为了能够精确地建立轻、中、重液压冲击分级脑损伤动物模型,我们设计了侧位液压冲击脑损伤装置。该装置由不锈钢储液管、压缩空气、减压设备及计算机等组成,可以精确地控制冲击气压的大小、记录冲击时脑组织所承受的压力、显示压力曲线、液压冲击后可以迅速释放系统内的压力,国内、外均未见报道。侧位液压冲击脑损伤随冲击压力的增加而加重,以冲击侧大脑半球为最重,也可波及对侧及脑底部。     

Impact of a preceding striatal excitotoxic lesion and treatment with ciliary neurotrophic factor on striatal graft survival

The survival of grafted embryonic striatal tissue, dissected from the lateral ganglionic eminence, depends on the status of the host striatum. We found significantly larger volumes of surviving graft tissue and of striatal-like tissue (P-zone) within the graft, when the host striatum had been subjected to an excitotoxic lesion prior to transplantation surgery. Concomitantly the numbers of surviving grafted cells, assessed in both cresyl violet-stained sections and in sections stained with an immunohistochemical marker for striatal neurons, increased as compared to when graft tissue was placed in an intact unlesioned striatum. Finally, we examined the impact of treatment of the donor tissue with ciliary neurotrophic factor (CNTF) on graft survival. CNTF has previously been shown to protect striatal neurons against excitotoxic insults both in vitro and in vivo, but it did not improve striatal graft survival when added to the cell suspension prior to implantation.     

骨科下肢侧卧位手术牵引架的研制及临床应用

目的研制并临床验证一种简便、实用、灵活、科学的骨科下肢侧卧位手术牵引架.方法1999年1月～2003年1月采用本手术设备共进行了51例均在侧卧位状态下进行的手术;其中股骨粗隆间骨折23例、股骨粗隆下骨折4例,行DHS22例、Gamma钉5例;股骨中下段骨折24例,行股骨交锁钉3例、梅花钉3例、LCDCP18例.结果采用本手术设备的手术情况是DHS、Gamma钉组的平均手术时间为51±19min、出血量为100士57ml,交锁钉组的手术时间为70±19min、出血量为312±94ml;与常规的仰卧位手术比较P＜0.01,同时方便C-臂X光机透视,尤其是侧位透视.此外,还可运用本手术设备进行股骨中下段骨折的其他各种内固定手术,牵引效能好,方便术区皮肤消毒及术中骨折复位.结论本骨科下肢侧卧位手术牵引架结构简单、零部件少、装卸容易、适应症广、操作方便、利于C-臂X光机透视,术中出血量少、损伤小、手术时间短,具有较好的实用型、先进性、科学性,值得临床推广应用.     

甲状软骨侧切术治疗声门旁间隙病变

目的：探讨经一侧甲状软骨板入路行声门旁间隙手术的可行性和优越性。方法：3例位于声门旁间隙的喉黏液囊肿患者，采用一侧甲状软骨“U”形部分切除术入路切除囊肿；1例喉外伤声门旁间隙异物采用一侧甲状软骨板垂直切开取出异物。结果：3例喉黏液囊肿患者随访1年均无复发，声音恢复正常状态；1例喉外伤异物患儿术后双侧声带运动正常，声门闭合良好。结论：经一侧甲状软骨板切开或部分切除入路，可清晰显露声门旁间隙，在直视下彻底切除囊肿或取出异物，手术创伤小，不破坏喉的框架结构，不损伤喉黏膜，术后无并发症，是处理声门旁间隙良性病变的理想手术方式。     

Foot pressure and radiographic outcome measures of lateral column lengthening for pes planovalgus deformity

The purpose of this study was to establish and characterize the relationship between foot pressure analysis and radiographic measurements in children that underwent a lateral column lengthening procedure for pes planovalgus (PPV). Eight children (13 feet) with PPV that had failed non-operative treatment underwent a lateral column lengthening procedure. Pre-operative and post-operative standing AP and lateral radiographs and foot pressure data were obtained. The relationships between the radiographic and foot pressure measurements were investigated. The findings from this study demonstrated strong relationships between these parameters. The relationships seen in this study indicate that the addition of foot pressure analysis provides objective documentation of the improvement in foot pressure distribution following a lateral column lengthening. Also, there is a direct, positive relationship between the key radiographic and foot pressure measurements.     

A di-synaptic projection from the lateral cerebellar nucleus to the laterodorsal part of the striatum via the central lateral nucleus of the thalamus in the rat

We have examined a cerebello–thalamo–striatal pathway from the lateral cerebellar nucleus (LCN) to the laterodorsal part of the striatum (LDS) through the central lateral nucleus (CL) using light and electron microscopy through the employment of a combination of anterograde and retrograde tracing techniques. Biotinylated dextran amine (BDA) was injected into the unilateral LCN, and used as an anterograde tracer. Cholera toxin B subunit (CTb), used for light microscopy, and wheat germ agglutinin–horseradish peroxidase (WGA-HRP), used for electron microscopy, were injected into the contralateral LDS as retrograde tracers. Light microscopic analysis showed a good overlap of the distribution of BDA-labeled axon terminals and CTb-labeled neurons in the middle third of the CL in both dorsoventral and rostrocaudal axes on the LDS injection side. Electron microscopy confirmed the presence of direct synaptic contacts between BDA-labeled terminals and WGA-HRP-labeled dendrites in the CL.     

Expression of immunoregulatory cytokines in neurons of the lateral hypothalamic area and amygdaloid nuclear complex of rats immunized against human IgG

Present results showed that interleukin-1 (IL-1), IL-6 and transforming growth factor-beta (TGF-beta) were constitutively expressed in the supraoptic and paraventricular nuclei of the rat hypothalamus. Immunoreactive cells were also detected, but to a lesser extent, in other parts of hypothalamus as well as in the cerebral cortex. In rats immunized with IgG, there was moderate increase in immunoreactivities of the cytokines. A notable feature, however, was the induction of the cytokine expression in the lateral hypothalamic area and the amygdaloid nuclear complex, suggesting that the neurons in these two areas are involved in possible immune regulation.     

集合不足型外斜视外直肌斜向后徙

目的　评价集合不足型外斜视外直肌斜向后徙的效果。方法　研究组 2 2例 ,对照组 8例 ,看近斜视角大于看远斜视角至少 15PD ,研究组 2 2例行外直肌斜向后徙术 ,对照组 8例行标准的外直肌后徙术。结果　研究组 18/2 2术后看近外斜度≤ 10PD ,2 2 /2 2术后看远外斜度≤ 10PD ,看近看远外斜角平均差值由术前 2 5± 8 11PD减少到术后 5 2 3± 4 0 3PD。对照组仅 3 /8术后看近外斜度≤10PD ,6/8术后看远外斜度≤ 10PD。结论　集合不足型外斜视外直肌斜向后徙术效果优于标准的外直肌后徙术。     

旋股外侧动脉升支肌骨瓣治疗髋部病损

髋部病变造成的股骨颈骨缺损及股骨头缺血性坏死病例的治疗方法较多。80年代以来,随着显微外科及修复外科的发展,利用带血管蒂的肌骨瓣、骨膜瓣修复髋部病损的新方法开始用于临床[1~3]。作者近6年来采用旋股外侧动脉升支阔筋膜张肌髂骨与骨膜瓣转位治疗髋部病损31例,获得满意效     

Surgical management of medial and lateral elbow instability secondary to acute atypical complex elbow dislocation: Case report and literature review

Introduction and importanceElbow dislocation is common in adults, and complex elbow dislocations are generally associated with bone fractures. Anteromedial coronoid fracture, in association with lateral collateral ligament (LCL) disruption, often results from varus posteromedial forces. “Terrible triad” injuries are more likely to result from valgus posterolateral forces. However, our case presentation has combined medial and lateral elbow instability in addition to “terrible triad” injury of the elbow with no radial head injury.Case presentationThe patient was a 38-year-old man with an atypical complex elbow dislocation. He was successfully treated by stabilizing the medial epicondyle and coronoid anterolateral facet fractures, in addition to LCL repair and medial collateral ligament (MCL) reconstruction. A radial head fracture was unnoted. The procedure yielded satisfactory functional outcome, with a stable and painless full elbow range of motion.Clinical discussionMulti-ligament injuries with coronoid fractures result in highly unstable elbow joints, forming a variant of the “terrible triad” injury. Surgical options vary according to the surgeon’s experience and equipment availability. In this case, direct LCL repair and MCL reconstruction were performed and were well tolerated. Elbow stability improved and the patient experienced improved functionality with minimal pain. However, it may be premature to report a definite outcome in this case because of short follow-up time postoperatively.ConclusionThe injury described in this case has a unique presentation as a multi-ligamentous injury will make the elbow very unstable. Thus, careful clinical judgment, knowledge, and experience are needed to identify the underlying injury and for optimal management.